Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,644.66 / $9,972.00 / $20,400.00	Facility		$1,644.66	$9,972.00	$20,400.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $1,194.52 / $1,705.34 / $1,920.04	Professional		$1,194.52	$1,705.34	$1,920.04
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $975.86 / $1,521.85 / $2,098.10	Facility		$975.86	$1,521.85	$2,098.10
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $1,046.52 / $1,431.79 / $1,502.14	Facility		$1,046.52	$1,431.79	$1,502.14
Providence Facility/Professional Facility Modifier Low / Median / High Price $975.86 / $1,634.93 / $2,098.10	Facility		$975.86	$1,634.93	$2,098.10
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $8,508.06 / $10,952.22 / $13,050.49	Facility		$8,508.06	$10,952.22	$13,050.49
United Facility/Professional Facility Modifier Low / Median / High Price $2,155.00 / $12,835.00 / $26,404.00	Facility		$2,155.00	$12,835.00	$26,404.00